Lista de verificación de Rolling Tower/Baker/Perry

• Jobsite Location:
  Address

• Job #

  Select

• Date of Inspection:

  Date

• Weather - Select all that apply

  Select

• Superintendent (s):

  Select

• Competent Person:

• Prepared by

Scaffold Incpection

• Are outriggers (if required) properly installed on both sides of rolling towers?

  Yes

  No

• Are platforms fully planked with no gaps greater than 1 inch?

  Yes

  No

• Are wheel brakes operable, and have employees been instructed to set brakes while in<br>use?

  Yes

  No

• Are safety rails installed at the 6-foot level, or some other type of fall protection?

  Yes

  No

• Have employees been properly instructed in the safety procedures for using rolling<br>tower, Baker or Perry Scaffolds?

  Yes

  No

• Have caster or wheel stems been pinned or otherwise secured to prevent them from<br>coming separated from the scaffold legs?

  Yes

  No

• The load limit for this scaffold is ________________ lbs.

• Inspection results

  Pass

  Fail

  Action Required